Docteur Philippe Chout

Chirurgien plasticien inscit à l'Ordre des Médecins de Paris en France




CHIRURGIE ESTHETIQUE DES SEINS , AUGMENTATION MAMMAIRE PAR LIPOFILLING ET TRANSFERT DE GRAISSE


Le lipofilling mammaire augmentation du volume de la Poitrine
Le Docteur Philippe Chout est inscrit à l'Ordre des Médecins de Paris en France


par le Docteur Philippe Chout - Chirurgie Plastique et Esthétique Ancien Interne des Hôpitaux de Paris - Ancien Chef de Clinique à la Faculté de Médecine Spécialiste inscrit à l’Ordre des Médecins de Paris n° 64 900, 75 Email : doctorchout@ ymail.com


Le lipofilling mammaire

Le lipofilling mammaire est une opération qui consiste à injecter la propre graisse du sujet dans et autours des seins ; il s’agi t d’une autogreffe de tissus- adipeux. La technique du transfert de tissus adipeux lipofilling, devient très populaire chez les femmes qui souhaitent une augmentation de la poitrine sans avoir à recourir à des prothèse artificielles en gel de silicone. Le lipofilling mammaire est une chirurgie fiable et sûre pour augmenter modérément le volume des seins. Elle a été validée par L’HAS , la haute autorité de santé, pour la chirurgie plastique réparatrice, avant d’être autorisée en chirurgie esthétique. L’opération d’augmentation mammaire par injection de graisse dans les seins, aussi appelée lipofilling mammaire consiste en l’injection de graisse pour augmenter le volume des seins. La réinjection de la propre graisse de la patiente dans ses seins permet d’augmenter le volume mammaire. C’est donc une technique naturelle sans introduction de corps étranger. Elle n’augmente pas le risque de cancer du sein.



Vidéo avant après augmentation mammaire silicone voie axillaire et lipofilling seins et fesses

Résultats après pose de prothèses mammaires préremplies de gel de silicone par voie axillaire en arrière du muscle pectoral. La forme anatomique et naturelle est obtenue en choisissant des implants de profil haut 330 cc poistionné sous le méridine et en abaissant le sillon sous mammaire. Il est important de bien libérer, et fragmenter le sillon sous mammaire pour éviter l'aspect en double sillon qui est si inesthétique. Par ailleurs le transfert de graisse sous cutanée dans la région du décolleté évite les plis viisbles. L'image ci-dessous est la même patiente avec le soutiensgorge

Les indications du lipofilling des seins

Le lipofilling des seins s’adresse aux femmes qui souhaitent :

- Soit augmenter le volume de la poitrine de façon modérée,
- Soit gagner un ou deux bonnets de soutien-gorge. Par exemple passer d’une soutien gorge 85 B à un 85 C.
- Soit obtenir un bombé du haut des seins pour améliorer le bombé xu décolleté.

- Cependant les femmes qui désireraient une augmentation de volume importante, il est plutôt préconisé la pose de prothèse mammaire, laquelle peut être accompagnée aussi d’un transfert de tissus adipeux.
- Le transfert de graisse peut aussi être utilisé pour épaissir le panicule cutané et ainsi dissimuler des côtes trop visibles au-delà de la base des seins, ce que ne peut pas faire un implant. Ces deux techniques se complètent très bien on le voit ...
- Corriger certains défauts dus aux prothèses par exemple quand les implants sont visibles sous la peau chez la femme mince et qu’elles font un effet de vagues.
- Le lipofilling par injection de graisse permet également d’obtenir un effet de lifting du sein en maintenant mieux la poitrine ,
il peut atténuer légèrement la ptôse au niveau du sillon mammaire lorsque les seins sont légèrement moins tendus et moins fermes afin de gagner un peu de tonicité.
- Redonner de la fermeté et de l’élasticité à des seins moins tendus.
- Lisser par remplissage un décolleté fripé y compris devant le sternum, comme l’on voit après le sommeil.

Il est indispensable que a patiente aie suffisamment de graisse suffisantes, car chaque fois que l’on prélève 100 cc de graisse, après purification il ne reste que 40 cc de tissus adipeux viable que l’on peut réinjecter. Les patientes trop minces qui auraient le plus besoin d’un transfert de graisse sont hélas celles chez lesquelles, cette technique est parfois inefficace … faute de graisse en quantité et en qualité suffisante. Les récentes recommandations de la Haute Autorité de Santé (HAS) n’impose plus l limite d’age,de 35 ans pour le lipofilling mammaire. Par principe de précaution, on évitera toutefois l’intervention chez la femme qui a des antécédents familiaux de cancer du sein.

augmentation mammaire par lipofilling transfert de graisse

Déroulement de l’intervention pour lipofilling mammaire.


Peut-on réinjecter directement la graisse prélevée? Non justement !

La graisse, une fois prélevée doit être soigneusement préparée avant d’être réinjectée dans les seins. Lorsque le chirurgien esthétique prélève la graisse, elle est impure. Une purification est réalisée par filtration graisseuse et centrifugation, étape minutieuse qui prend du temps. C’est finalement la graisse pure qui va être réinjectée dans la zone mammaire à l’aide de fines canules. Les seins gagnent ainsi en volume et en galbe.

L’intervention d’augmentation mammaire par injection de graisse dure entre 1h et 2h. L’opération peut être réalisée en ambuatoire mais, en fonction des zones à prélever, la durée de séjour à la clinique est plutôt de 1 nuit. L’augmentation des seins est en général réalisée sous anesthésie générale. La patiente est endormie et ne ressent rien pendant l’intervention. La réinjection de graisse dans les seins est en général peu douloureuse. En revanche, il peut y avoir des douleurs au niveau des zones de prélèvement de la graisse. Les patientes les décrivent souvent comme de « grosses courbatures. » Des antalgiques appropriés sont alors prescrits. Il n’est pas nécessaire d’arrêter la pilule avant l’opération. L’opération commence par faire une infiltration au sérum des zones à aspirer et une lipoaspiration douce suffisantes, le plus souvent au niveau des de la culotte de cheval , des hanches ou de l’abdomen. La graisse obtenue est alors lavée méticuleusement, purifiée et centrifugée , afin d’obtenir du tissus adipeux pur. Ensuite ce greffon est répartit dans les seins à l’aide de très fines canules (= aiguilles) de 2 mm. Je n’injecte pas plus de 200 centimètres cubes de graisse par sein afin d’optimiser les chances de réussite de la greffe.

Les avantages lipofilling mammaire par le tissus adipeux du sujet : - Il n'y a pas risque de rejet d’allergie ou puisque la graisse utilisée est celle de la patiente.
- Il n’y a pas de cicatrices, juste de très fines incisions dissimulées sous le pli du sein.
- Il n’y a pas risque de coque mammaire comme cela est possible dans le cas des prothèses en silicone.
- La poitrine est augmentée et dans le même temps opératoire la silhouette est affinée, ce qui est une combinaison très esthétique.
- Souvent maintenant chez les femmes minces ayant peu d’épaisseur de glande et de graisse, on associe d’emblée le lipofilling des seins avec la pose d’implants.
La graisse matelaasse et sépare mieux la prothèse de la superficie de la peau ce qui donne un aspect plus naturel.

Les suites après un lipofilling des seins
En fin d'intervention, le chirurgien referme les incisions avec du fil résorbable et pose un pansement et un soutien-gorge de contention en coton sans armature qui se ferme devant, type Triumph sport ou équivalent. Il y aura un œdème modéré et des ecchymoses qui se résorbent en quelques semaines. Il est conseillé de se reposer pendant trois à sept jours et de porter le soutien gorge de façon continue jour et nuit. La douche est possible dès le lendemain de l’opération. La reprise du sport peut se faire après un mois. Les risques et les complications possibles du lipofilling mammaire

Réalisée par un Chirurgien qualifié en Chirurgie plastique, reconstructrice et esthétique dans une clinique agréée pour la Chirurgie esthétique, le lipofilling mammaire est une intervention maîtrisée. Comme toute chirurgie des complications sont rares mais possibles, elles sont détaillées dans la fiche d’information de la Société Française de Chirurgie esthétique et plastique et vous seront expliquées lors de la consultation. Bien gérée, une complication laisse peu ou aucune trace. Le suivi post opératoire est donc indispensable.

Les complications possibles sont l’hématome, l’infection, la cytostéatonécrose. L’apparition de microcalcifications à la mammogaphie. Les questions médicales de cette évaluation portent principalement sur la sécurité de l’acte d’autogreffe de tissu adipeux dans le sein. Prenant en considération la diffusion en pratique clinique de la technique de l’autogreffe de tissu adipeux et l’absence de signal négatif sur les aspects de sécurité de cet acte, la HAS considère, que l’autogreffe de tissu adipeux constitue une modalité chirurgicale possible dans la chirurgie réparatrice, reconstructrice et esthétique du sein, en dehors de la symétrisation du sein controlatéral au décours d’une chirurgie carcinologique mammaire.

Les contre indications d’un lipofilling mammaire Il faut éviter de réaliser un lipofilling mammaire en cas d’antécédent de cancer du sein ou de l’ovaire personnel ou familial, de lésions mammaires atypiques , de bilan sénologique classée AC3 ou plus , d’antécédent d’irradiation du thorax. Les dernières recommandations de la Haute Autorité de Santé ne posent pas de limite d’âge pour réaliser un lipofilling des seins

Les résultats du lipofilling mammaire
A condition qu’il y ait suffisamment de graisse à prélever , l’augmentation du volume mammaire obtenue est en général de 100 à 200cc, c’est à dire un bonnet , voire deux au maximum dans les cas les plus favorable. La graisse peut avoir plus de mal à s’intégrer dans son site d’implantation mammaire au delà de ces volumes. Le résultat du lipofilling mammaire est certes visible immédiatement, mais il sera définitif qu’après trois mois quand la greffe aura pris. Il est tout à fait normal qu’il y ait une légère perte de volume dans les semaines qui suivent l'intervention. . Dans les cent premiers jours, l’oèdème va diminuer et les greffons vont prendre dans le site receveur. En général la prise est de l’ordre de 80%. Les seins sont plus gros et plus fermes. En fonction de l’augmentation du volume souhaitée, de une à trois séances pourraient être nécessaires. L’apparence de la poitrine est très naturelle. Une fois que la greffe de graisse a pris, elle est définitive. Les cellules graisseuses étant un tissu vivant, en cas de prise ou de perte de poids, les seins augmenteront ou diminueront aussi de volume.

Quels sont les tarifs du lipofilling mammaire ? Le prix d’un lipofilling des seins est variable. Le tarif d’une réinjection de graisse dépend des gestes à réaliser, des quantités à injecter, du nombre de séance prévues, de la durée de séjour à la clinique et de ses tarifs, de la clinique, des qualifications du chirurgien et de ses titres, des zones où il faut prélever la graisse… Seul le devis individuel et personnalisé remis en consultation est contractuel.

700


1010 lien vers page anglais



Breast Augmentation, Breast Reduction and uplift, Mastopexy


Breast augmentation surgery uses silicone breast implants placed behind more often than on top of the pectoralis muscle, behind the breast teh actual patient's breast tissue. The quality of the result is relatd to the patient's skin and deeper tissue quality. The result is better when the Lady is not too skinny , other wises some rippling and double bubble ay show. The treatment for these is the fat transfet that should ideally be performed together with the initial surgery. Sometimes when braest are too big or sagging breast requires a breast up-lift mastopexy. The breast reduction is a different procedure called mammoplasty.

870


BREAST AUGMENTATION

Why have a breast enlargement operation?


The reasons why you may choose to enlarge your breasts include:
- feeling that your breasts are too small
- loss of breast volume after pregnancy (although enlargement will not lift them)1
- a difference in size between your two breasts
- reduced breast size after losing weight



Cette jeune femme a bénéficié d'une augmentation mammaire par prothèse posée par voie axillaire et complétée par un transfert de graisse dans le décoletté et les fesses




Dr. Philippe Chout Breast augmentation from a 32 A Cup to a 24 D cup, with silicone implant placed via an incision hidden in the armpit. A nice and fuller Bikini Cleavage was obtained. Patient's answer at minute 03:00 of the video track, to Dr.Philippe Chout question : " were you worried before the operation ?" Patient's answer quote : " Not really because I have many friends who have had things and procedures done by you, their breast done, noses,liposuction, so no I wasn't worried as they were all very happy" . At minute 3:52 of the video track, Dr. Chout say : "... so you wanted to have your Bikini Breast and you've got them... Are you happy ? Patient's answer, quote : " Yes ! Really very very happy... Its a very happy Bikini story, thank you very much Doctor Chout !" end of patient'squote.


Vidéo petite augmentation mammaire par prothèses

Cette jeune femme a bénéficié d'un petite augmentation mammaire par prothèes de 240 cc posées par voie axillaire .L'apparen eet le toucher des seins sont très naturels!


Vidéo. before / after breast augmentation. Review Dr. Philippe


This young Lady benefited from breast augmentation with siicone implants, large breast enlargement generous cleavage. The patient's size Bra grew from a small B cup (not even full) to a full D cup bra. The implants do not show at all and you cannot feel them at all when touching, the breast is soft.

1300


Before the breast augmentation Operation

The implants that are nowadays authorized have an envelope of silicone; it does contain silicon gel or physiologic serum. When they are filled with physiologic serum, they contain salt water. This liquid does not present any danger to the organism but it consistence when touching is often not that of a natural breast. The silicone filled implants have a smoother consistence and less folds but the risk in rare case of silicone leak is local granuloma or rare inflammation away from the implant.
The harmlessness of the mammary implants, at a cancer point of view, is proven, they do not provoke cancer and do not bother the normal surveillance of the breast. There is no association between silicone breast implants and connective tissue diseases. (Harvard Brigham's Hospital survey on 87 000 women 1995) The placement of the mammary implants does not contradict either pregnancy or breast-feeding, but pregnancy and breast-feeding always alter the shape of the breast. Breast-feeding is possible after the placement of the mammary prosthesis due to the fact that they are placed behind the mammary gland and do not interfere with lactation. The prosthesis needs to be changed after fifteen years (20 years in the best case scenario for silicone filled implants by the maker McGhan), ten years for saline.

Can the breast implant leak?

Breast implants leak in less than 10 percent of women and this usually starts six or more months after surgery. The breast implant often has to be removed. The contents of the implant can either leak slowly through the coating, or suddenly if the implant breaks open. This can lead to pain and an abnormally hard feel to the implant in the breast. The body naturally forms a fibrous capsule around the implant, which helps to contain the contents of the implant. The newer designs of breast implants have features to reduce the likelihood of the implant leaking or breaking. There have been concerns that leaking breast implants may be linked to serious health problems such as cancer but there is no conclusive evidence to support this. Mammary prosthesis are foreign bodies to the organism, their presence can create a fibrosis reaction around the implant, resulting in the formation of a shell = capsular contracture= encapsulation. The breast becomes harder, higher and round and even sometimes painful. If this eventual shell is of importance and resists medical treatment (external squeezing), an intervention to remove the shell could be necessary at the patients's expenses (less than 10 % of the cases).


Will the implant affect mammography?

Breast implants interfere with mammography, a low-dose X-ray of the breast tissue used to detect cancer.3 You should let the radiographer or nurse know that you have implants as special X-ray views can be taken to minimise this interference.

919

Breast augmentation Technique, incisions and scar

The prosthesis could be placed by way of the axillaries (armpit), by way of the areola, or by way of the crease underneath of the breast according to the surgeon's choice. The final volume of the breast and the letter of the bra are variable between different brands of bra. The Surgeon will only place the implant that you will have chosen, and is not therefore responsible for the final size of the bra. The breast being involved in the couple's intimacy, it seems imperative that you obtain the approval of your partner before the intervention, and deliver him the information you have received. Photographs will be taken before and after the intervention. The Surgeon will take into consideration your natural asymmetry while performing the operation, but perfect symmetry is not guaranteed. A mammography seems necessary if you are over 35 years old (to be prescribed by your GP).



review-dr-philippe-chout-breast-augmentation-surgery-results.jpg

breast-enlargement-scar-dr-philippe-chout-website-reviews-3.jpg

The Operation

The intervention is brief; it lasts about one and a half hours. The operation will take place under a general anaesthesia. A pre-operative consultation with an anaesthesiologist will take place before the operation. This doctor will be responsible of all the medical aspects of your operation. You won't breathe spontaneously during the operation, but through a machine. Some biological blood test will be prescribed before operation. Do not take aspirin or any medication containing aspirin within the eight days that precede the operation and that follow the hospitalization, due to the fact that this form of medication increases the risks of haemorrhaging. All anti-inflammatory drugs will be also avoided pre and post operatively. The duration of hospitalization is normally 24 hours; it could be longer depending on the secretion in the drains.

After the operation

Professional activity can be continued generally on the eighth day if it is office work. The cut will be closed with stitches. If these are not dissolvable, they will be removed about a week after surgery. Bandages or dressings will be applied over the operation area. Illustration showing the position of breast implants What to expect after the operation. You will be given painkillers to help relieve any discomfort as the anaesthetic wears off. Before you go home your nurse will give you advice about caring for your breasts, hygiene and bathing. He or she will also give you advice about wearing a special supportive bra in the days after the operation.

The post-operative consultations (7th and 14th days, 30 days, 60, 180, 360 days) must be attended by the patient and she should adheres to the surgical prescriptions and the placement of an elastic constraint that adjusts the position of the prosthesis and keeps it in place with the support of a particular kind of bra. The position of the implant and therefore the shape of the breast is controlled by the bandage in the first weeks following the intervention, hence the necessity to come to all consultations. The final cosmetic result is limited by the amount and quality of previous skin and breast tissue, but also their relative symmetry... After operation you will initially have a compressive dressing that should stay untouched for approximately one week. When it will be taken off, you'll take a shower every day, rinse, dry and apply antiseptic solution and cover with a sterile dressing. The pains that the intervention may cause, disappear after a couple of week thanks to pain killers and myorelaxants. The first two weeks, a tense sensation and a discomfort during normal movement of the arms are usual.

Bruising swelling and the crackling underneath the skin are normal and will decrease in eight days. It is usually possible to return to work after the 8th day. Sexual intercourse will be avoided for three weeks. You must avoid the loss of large amounts of weight, in order to avoid making the implant visible and perceivable. Sometimes one can see perceptible folds or ripples under the skin (less folds with silicone filled implants) this is a possible inconvenience in case of skinny body or very small breast and fat tissue on the chest.

Video to suitable for people under 18 years old.

deciding to have breast augmentation with implants


It's important not to rush into the decision to have any cosmetic operation. And it's sensible to discuss the options with your GP. Breast enlargement is a commonly performed and generally safe operation. For most women who want the operation, the benefits in terms of improved appearance outweigh the risks. However, if you are deciding whether or not to have this procedure you need to be aware of the possible side-effects and the risk of complications.

temporary effects of a successful procedure. An example is feeling sick after the general anaesthetic. Anyone having a breast enlargement can also expect:
- pain, swelling, tenderness and bruising for at least a few days
- a burning sensation in the nipples for a few weeks, but this should go away as you heal

Complications

They are unexpected problems that can occur during or after the procedure. Most people are not affected. The main complications of any operation are bleeding during or soon after the procedure, infection and an abnormal reaction to the anaesthetic. Specific complications of breast enlargement include those listed below.
- You may get an infection in the breast. If this happens, the implant may need to be temporarily removed to allow the infection to be completely treated.
- Abnormal scar tissue can form around the pocket in which the implant sits. This may squeeze the implant and cause firm, painful breasts. This is known as capsular contracture. If the breast goes hard, further surgery may be required.
- There is usually a temporary difference in skin and nipple sensation following breast enlargement but this can be permanent.
Complications in this surgery are rare but may require returning to theatre:
Haematoma and infection, skin necrosis, localized permanent loss of sensitivity, chronic pain - Some leakage of liquids like lymph or silicone is a very rare event, they causes the replacement of the implants. Skin necrosis, re-opening of the wound, poor scarring, and keloid scar, double bubble. Implant moving while the pectoralis muscles are contracting, is more a side effect than a proper complication.
A shell (capsular contracture) if important can lead to a second operation. A shell can occur is approximately 10% of cases. Then the breast becomes harder, rounder and higher. Sometimes it can become painful. Fluid can build up around the implant. This is called a seroma and may require further surgery to remove. There may be a difference in size and shape between the two breasts,
possibly caused by your previous natural differences that are highlighted by the surgery. Remember cardiovascular, neurological complications, respiratory or immunoallergic, are sometimes lethal or invalidating with anaesthesia, they can evolve unto themselves.


Breast Augmentation + Uplift ( mastopexy)


A particular case is that of a woman that presents, on one hand an insufficient volume of breast tissue and on the other hand a skin excess leading to a sagging breast (more than 22 cm between sternal notch and centre of the nipple). The only placement of an implant will not correct the falling and sagging aspect of the breast. It would just create big sagging breast. A re-draping of the skin by peri- areolar concentration, or preferably with an anchor shape T inversed scar, could be necessary right away or at a later date. This is an additional procedure that will be charged separately.



BREAST REDUCTION OR UPLIFT


The principle of this procedure is to reduce the amount of skin only (up-lift) or also breast tissue itself at the same time, and to place the breast higher by reducing the skin excess. The scars involved by this operation are permanent. You should inform your partner about all the aspects of the operation.


Before The Breast reduction or uplift Operation

The amount of skin and breast tissue to be removed will be measured by palpation. Some photographs will be taken before and after the intervention. A mammography will be performed if you are over the age of 35 (prescribed by your GP). The operation will take place for the most part under general anesthetic, a consultation with an anesthesiologist, before the operation, is therefore necessary. The duration of the operation is approximately 3 hours. During the operation you won’t breathe spontaneously, but through a machine. You must stop taking oral contraceptives (the Pill) one month before the intervention, and must wait 2 months after the intervention before re-starting. You must allow at least 12 months between the time of the operation and the beginning of a pregnancy. Breast-feeding is generally impossible after mammary plastic surgery to the posterior pedicle. The duration of hospitalization (average of 3 days) depends on the secretion in the drains. It is recommended to come to the clinic with a nightshirt that closes in the front and a wire-less bra that also closes in the front. The model triumph sport Tri-action is a good bra that is available in all large department stores. Their size does not pre-determine the size of your bras after the intervention.


After The Operation

The days following the operation are generally not very painful. Very frequently, the operation improves the back pain suffered by women with very large breasts. This also makes sport and clothes shopping easier. It does not eliminate stretch marks of the superior quadrants of the breasts. The sutures used are essentially re-absorbable; those that are not will be removed in the course of the first month, during the consultations that will take place after your discharge from hospital. Asymmetrical bruising and swelling are common and normal with this surgery, they disappear within three weeks. The areas undermined or incised regain their sensitivity in the few months following the operation. Areola sensitivity will remain modified. During the months following the intervention you should take a shower each day, during which you wash the breasts with a gentle antiseptic soap and gauzes. The quality of this care determines the overall results. After the shower you must place dry gauze on the breast, which is held in place with the bra, which will be worn day and night for a period of one month post-operatively.

You must avoid to strain yourself postoperatively
• Professional activity can continue a minimum of two weeks after the intervention.
• Carrying heavy burdens is prohibited for five weeks.
• Sports activities can be resumed after five weeks.
• Obviously, sex relations during this period should not involve the breasts. Or should be avoided.
• Breast-feeding after this surgery is usually not possible.

Scars are permanent even if they are discrete. They are situated horizontally in the crease below the breast, vertically from that crease to the areola, and around the areola. In the case of very extreme reductions, they may go beyond the furrow under the mammary. Their evolution is rather stereotyped, with a period of inflammation and itchiness during the first trimester. The final look of the scar is not predictable. In some rare case the scar could stay thick, red elevated, painful and visible (Keloid scar). Sometimes tattooing (at the patients expenses) will help to make the scars less visible. Massaging the breast and squeezing the scars helps to soften the scars.


The complications are rare, but may include the following:

Haemorrhaging, Haematoma and infection that could call for surgical intervention A prolonged lymphoma or lymphorragia. Necrosis of the areola and of the nipple are rare. The disunion of the scaring contours is minor complications, but not rare, that regresses with simple repeated dressings done by a Registered Nurse . Excess of Fibrous tissue Chronic pain, loss of sensations and sensitivity. A defective scar, keloid or dystrophy of intrinsic origin can alter the cosmetic results and call for retouching. The definitive aspects of the scars are not predicable. For the record cardiovascular respiratory or neurological complications of general anaesthesia, deep vein thrombosis, thromboembolism or immuno-allergic, sometimes lethal or invalidating from anaesthesia which can evolve independently.


The results of breast reduction of up-lift

The morphological results can be estimated at a minimum of three months after. The first weeks after the intervention, the breasts are placed high and rounded at the superior part. They place themselves and round themselves out from the first month on. At the end of the first month you must begin day massaging of the scares with gentle almond oil. The final aesthetic results are obtained in the 9th month. This intervention brings about, most of the time, a large comfort and an aesthetic improvement to the women that are benefiting from it. A retouch under a local anaesthetic in order to improve tiny details is sometimes necessary (seldom).
Nipple Correction/
Inverted nipples
or big areola or nipple, this procedure can be done alone or with a breast reduction. The incision is located around the areola or below the nipple. It is necessary to have a dressing for a few weeks. Sometimes inverted nipple could go back in after the operation.


FIN DE PAGE AUGMENTATION MAMMAIRE PAR LIPOFILLING TRANSFERT DE GRAISSE


mirror-website-of-dr-philippe-chout-reviews.jpg



social-networks-follow-dr-philippe-chout-reviews-website-avis-site-internet.jpeg




- Copyright All Rights Reserved - Dr Philippe Chout- tous les droits sont réservés- Article L335-2 modifié par loi française n°2016-731 du 03/06/ 2016 - art. 44 />